I Have Natural 30E Breasts How Much Can I Add Without the Implant Being Visible?

Question

I have natural 30E breasts. I want to add volume to them. However I don't want the implant to be visible when I'm bouncing around during intercourse; I also want to keep their natural 'jiggle'. So two questions: Assuming I'm Jane Average, how much could I likely add without ruining the jiggle? Other than using less volume, what could a surgeon do to preserve the precious natural-boob jiggle? I'm 5'4,120lb,28yr,30E breasts which displaced 475mL when dipped in a Pyrex cup (I was just curious).

Leila Kasrai, MD, FRCSC · Answer

It sounds like you are already naturally large breasted, particularly considering you are just 5’4” and 120lbs. It might not be suitable for your body type to add more volume to your breasts, as you could end up with back/shoulder pain and other health issues caused by overly large breasts. In addition, due to them being “jiggly”, adding implants will accelerate their rate of sagging.

Gary M. Horndeski, MD · Answer

At size 30 each 100 cc of implant will correspond to 1 cup size change.  The 474 mL you measured corresponds to a size E.  The answer to your 1st question is the more volume added to the breast the more the breast will displace with motion.  However, if you want to prevent that from happening, the best technique is to place the implants completely behind the muscle.  The answer to your 2nd question is to use a new technique called The Mini Ultimate Breast Lift.  With this technique only a circumareola incision if required to lift the breasts higher on the chest wall, increasing upper pole fullnessm cleavage and projection without an implant.  This technique would allow you to avoid the fake look of implants and preserve the natural jiggle you desire.

	Best Wishes,

	Gary Horndeski, M.D.

James E. Murphy, MD, FACS · Answer

Without at least a picture it is very hard to determine what to recommend. It sounds by your explanation that you have naturally large breast. And it sounds like you are pleased with the look you have. If that is the case, I would recommend staying with what you have, naturally.

Richard H. Tholen, MD, FACS · Answer

Thanks for the additional information; I answered your earlier question on the basis of an erroneous assumption that you already had 470cc implants. Using Archimedes' displacement is an excellent way of estimating present breast volume, though 475cc would typically correlate with a C-D cup (depending on bra manufacturer).

	Still, I have always contended that bra sizes are nothing more than "letters on a label" and they either fit well and look good, or not.

	Clearly you have large breasts with adequate skin laxity to provide "swing and jiggle," so over-filling your skin brassiere with too-large implants would not only reduce the desirable jiggle, but as others have said, will eventually lead to macromastia symptoms (back pain, neck pain, brachial plexopathy or ulnar paresthesias from bra strap pressure on your nerves, shoulder grooves, and cutaneous intertrigo) that breast reduction patients seek relief from via reduction mammoplasty.

	Yet, if you would like additional breast volume, you can figure about 250cc per cup size (other respondents will tell you 150-225cc, but I feel that is too low), and you should ask about the implant diameter for a given implant volume. In the size range that will not make you overly large, you will almost certainly want the widest base diameter (moderate profile) rather than narrower bases and more projection (moderate plus or high profile). For adequate implant width that will not slide around from side to side in your breast pocket, I would anticipate at least 250-300cc implants, if your goals and anatomy are in agreement!

	Incisions can be seen regardless of their location, so it is up to you to decide on the pros and cons of the various choices after discussion with your chosen ABPS-certified plastic surgeon, who will also be able to better advise you after physical examination of your own breast anatomy and skin tone.

	For the most homogeneous "feel" with your own breast tissue, choose the latest generation of cohesive silicone gel implants by any of the three US manufacturers. Saline implants may seem seductive because you have "enough" breast tissue of your own to "conceal" saline implants and minimize rippling, not to mention the smaller insertion scar.

	However, IMHO saline implants do not feel like breast tissue, leading to a "me plus implant" breast feel, rather than a homogeneous larger "my breasts," the scar length difference is only a few mm (and scars heal side to side rather than end to end), and they can still have visible or palpable rippling, which can increase the potential for leak and deflation requiring re-operation.

	Not that silicone implants are "foolproof," but they CANNOT leak, would take a tremendous blow to your chest to rupture them, and DO NOT require periodic MRIs to "look for silent rupture." Older generations of silicone gel, perhaps, but not the cohesive ones presently in use. The present generation of silicone gel implants feel much better, have the lowest likelihood for rippling (especially with your own larger breast tissue "cover"), and can NEVER leak or deflate. Any of the other implant issues for which patients request or require re-operation (size change, bleeding, infection, malposition, capsular contracture, etc.) exist equally for either saline OR silicone.

	For more information, please click on the web reference link below for my comprehensive guide to breast augmentation, and make one or more appointments with ABPS-certified plastic surgeons at your hospital or in your community. Best wishes! Dr. Tholen

Edwin C. Pound, III, MD · Answer

If you are an E-cup, I would think that you would be a better candidate for a breast reduction rather than a breast augmentation. I would think that you would be having back, neck, and shoulder strain from carrying around that much weight. Still, to answer your question, obviously, the larger the size of the implant, the more your tissue will stretch and thin out to cover it. Without examining you it is difficult to tell you what the optimum volume should be.

Kenneth Hughes, MD · Answer

Adding volume should be considered carefully in relation to back and neck pain later in life.  The jiggle preservation is difficult to assess without an exam.

Paul Gill, MD · Answer

Based on your description, you may not be a safe candidate for breast augmentation   In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
	Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
	The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
	I wish you a safe recovery and fantastic result.
	Dr. Gill

Norman Bakshandeh Day, MD, FACS · Answer

I dont think you are a candidate for implants from your description. Please post some photographs for more information

Steven Wallach, MD · Answer

It sound like you have significantly large breasts currently. I am not sure what you are trying to accomplish with implants?

Robert L. Kraft, MD, FACS · Answer

I would caution you against implants because you will be precipitating a whole new set of problems down the road, especially since you already have macromastia. Only a physical exam can determine whether you have enough tissue to cover the edge of the implant. Also, let me add that what you call the "previous natural-boob jiggle" will not continue with breasts of your current size and you can expect them to sag, based simply on gravity, over time even without an implant.

I Have Natural 30E Breasts How Much Can I Add Without the Implant Being Visible?

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